Background: Older adults continue to engage in and enjoy sex later in life and sex is beneficial to their health. However, less is known about the sexual satisfaction, frequency of sex, and erectile dysfunction of aging gay men, especially those who live in the Midwest. Materials and Methods: An online survey measured the relationship between internalized gay ageism and sexual health outcomes: erectile dysfunction, sexual satisfaction, and frequency of sex among gay men 50 years or older who lived in the Midwest (n = 181). Results: Internalized gay ageism was not significantly associated with erectile dysfunction or frequency of sex. However, age and overall health were associated with erectile dysfunction, while relationship type and income level were associated with frequency of sex. Mediation analysis showed a significant relationship between internalized gay ageism and sexual satisfaction through the mediation of body image.Conclusion: Clinicians, educators, and other health care providers should be aware of varying factors that influence sexual health outcomes among older gay men (e.g., relationship types, income levels, age, and overall health). Additionally, culturally competent interventions that address body image in consideration of the experience of being an aging gay man should be developed to potentially improve sexual satisfaction.
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